摘要
目的探讨显微外科技术联合透明质酸钠治疗手指屈伸肌腱损伤的临床疗效。方法选取2014年2月至2016年11月西安医学院第一附属医院手指屈伸肌腱损伤病人136例,采用随机数字表法均分成两组,一组给予显微外科技术联合可吸收止血膜(大清生物纸)治疗(对照组),一组给予显微外科技术联合应用透明质酸钠治疗(观察组),对比两组术后6个月的肌腱黏连情况。结果术后随访3~12个月,随访率100%,观察组伤口愈合良好,未发生红肿、渗液等症状,均为Ⅰ期愈合;对照组有2例伤口发生红肿,经抗生素治疗,均愈合良好;观察组远侧指间关节(DIP)屈曲度明显高于对照组(P<0.05)。术后6个月,观察组优良率为86.76%,远高于对照组67.65%,差异有统计学意义(Z=6.258,P<0.05)。术后6个月,对两组病人肌腱滑动距离和厚度进行超声检查,观察组肌腱滑动距离为(12.54±3.11)mm,明显长于对照组(9.30±2.94)mm,差异有统计学意义(t=6.243,P<0.05);观察组回声厚度为(3.26±0.46)mm,明显低于对照组(4.49±0.51)mm,差异有统计学意义(t=14.768,P<0.05)。结论采用显微外科技术联合透明质酸钠治疗手指屈伸肌腱损伤,可更好的降低术后肌腱黏连发生率,促进愈合,且较为安全。
Objective To analyses clinical application of microsurgical technique combined with sodium hyaluronate in the jury of flexor and extensor tendon of finger.Methods 136 patients with tendon injuries from February 2014 to November 2016 from Affiliated Hospital of Xi’an Medical University were grouped into two groups according to the random number table method.One group was treated with microsurgical techniques combined with Daqing biologic paper(control group).One group was treated with sodium hyaluronate on microsurgical techniques basis.Results FollowinG^-up for 3-12 months after operation,the follow-up rate was 100%.In the observation group,the wound healing was good and the symptoms of red and swollen fluid were not occurred,all of which were I healing.In the control group,2 cases had red and swollen wounds,and all were healed by antibiotics.The flexion degree of the flexion degree of distal interphalangeal(DIP)in the observation group was significantly higher than that of the control group(P<0.05).6 months after the operation,the excellent and good rate of the observation group was 86.76%,higher than the control group 67.65%,with statistically significant(Z=6.258,P<0.05).6 months after operation,the slipping distance and thickness of tendon of the two groups were examined by ultrasonography.The slipping distance of tendon of observation group was(12.54±3.11)mm,obviously longer than the control group(9.30±2.94)mm,and difference was statistically significant(t=6.243,P<0.05).The thickness of tendon of observation group was(3.26±0.46)mm,obviously lower than the control group(4.49±0.51)mm(t=14.768,P<0.05).Conclusion The use of microsurgical technique combined with sodium hyaluronate can reduce the incidence of postoperative tendon adhesion,promotes healing and is safer.
作者
张祥
胡柯军
孔祥丽
ZHANG Xiang;HU Kejun;KONG Xiangli(Department of Orthopedic Surgery,First Affiliated Hospital of Xi'an Medical University,Xi'an,Shaanxi 710077,China)
出处
《安徽医药》
CAS
2019年第7期1459-1461,共3页
Anhui Medical and Pharmaceutical Journal
关键词
肌腱损伤
显微外科技术
透明质酸钠
肌腱黏连
Tendon injuries
Microsurgical technique
Sodium hyaluronate
Tendon adhesion
